1. Field of the Invention
The present invention relates generally to a method and system for detecting swelling occurring as a result of increased water content in and around the brain. Specifically, embodiments of the present invention relate to detecting water content and measuring changes in microcirculation in and around brain tissue to facilitate diagnoses and monitoring of brain edema.
2. Description of the Related Art
This section is intended to introduce the reader to various aspects of art that may be related to various aspects of the present invention, which are described and/or claimed below. This discussion is believed to be helpful in providing the reader with background information to facilitate a better understanding of the various aspects of the present invention. Accordingly, it should be understood that these statements are to be read in this light, and not as admissions of prior art.
Edema may be generally defined as swelling caused by excess fluid in body tissues. Brain edema may be specifically described as swelling in the brain due to an increase in its water content, or as an accumulation of excessive fluid in the substance of the brain. Brain edema may also be referred to as cerebral edema, brain swelling, wet brain, swelling of the brain, and so forth.
The brain is especially susceptible to injury from edema because it is located within a confined space (i.e., the skull) and, thus, cannot expand. The human skull is essentially a rigid fluid filled container. Principle constituents within the skull include brain tissue, blood, and cerebral-spinal fluid (CSF). Because the skull is essentially rigid and has a constant volume, if there is an increase in the volume of the contents of the skull (e.g., as a result of brain edema), the pressure inside the skull (i.e., intracranial pressure) will rise unless some fluid is able to escape. For example, if the brain tissue experiences swelling, a certain amount of blood or CSF must escape the skull cavity to prevent a rapid increase in pressure. During such swelling, pressure inside the skull may rise above the normal range. Further, if swelling continues until little or no fluid remains, any further swelling will cause a rapid increase in intracranial pressure (ICP). A sufficient rise in ICP may cause compromised blood supply to the brain and herniation of the cerebral content through an opening in the skull. Thus, untreated brain edema may lead to neurological degeneration, loss of consciousness, and death.
Causes of brain edema include head trauma, vascular insults, abnormal metabolic conditions, infections, space-occupying lesions, and toxicity. The mechanisms of brain edema are cytotoxic and vasogenic. Cytotoxic edema is generally caused by neuronal damage that leads to increased sodium and water in the brain cells. Vasogenic edema is generally a result of vascular trauma causing leakage of protein from blood into the extracellular compartment. Water generally moves into the extracellular compartment as a result of increased osmotic pressure.
Brain edema may be suspected in a patient if the patient presents with a headache, vomiting, altered consciousness, and/or sensorium. Additionally, upon examination of the patient, further indicators may be observed. For example, the patient may be determined to have papilloedema (i.e., swelling of the optic disc) based on fundoscopy (i.e., examination of the interior of the eye), unilateral or bilateral motor posturing, changing breathing patterns, circulatory hemodynamics, and so forth. Diagnosis may be confirmed by imaging techniques such as a computed tomography (CT) scan. Once the diagnosis is confirmed, the ICP may be monitored (e.g., via placement of catheters in the cranial cavity).
Traditional techniques for monitoring and measuring ICP generally involve the use of invasive devices. For example, commonly used devices include hollow screw and bolt devices. These typically include metallic cylindrical instruments which are inserted into the patient such that an instrument tip protrudes into the subarachnoid space to facilitate pressure measurement. The subarachnoid space may be defined as the compartment within the spinal column that contains the CSF. Another commonly used invasive device for ICP monitoring is an intraventricular catheter. The intraventricular catheter is typically placed inside ventricles (i.e., fluid filled cavities) of the brain to facilitate pressure monitoring. Insertion of such invasive devices (e.g., hollow screws and catheters) to facilitate ICP monitoring can be undesirable.
Some existing techniques for monitoring ICP are non-invasive. For example, some existing methods involve emitting ultrasound into the patient's brain to facilitate detection of an elevated ICP. Such ultrasound emissions typically reach the brain through natural windows in the skull. For example, ultrasound emissions may be introduced to a patient's brain via an eye socket. However, these ultrasound emissions may be undesirable depending on how long the eye must be esonified. Further, sensor placement for such methods can be difficult, resulting in inaccuracies.